RCOG suggests caution over social egg freezing

This week the Royal College of Obstetricians and Gynaecologists (RCOG) issued a report suggesting caution over social egg freezing.

As we have discussed previously, a woman’s fertility decreases with age due to the decrease in the quantity and quality of her eggs.

Young women today have very different opportunities to their mothers and grandmothers. We are more educated, have better career options, can travel the world more easily, probably have a more active social life – all of which may delay finding a partner or deciding to start a family so that the average age of first conception is 30 years in many countries. But also men often want to delay starting a family, and they are not limited by age-related infertility as women are.

If a woman freezes her eggs, she has the potential to put her fertility on hold. But is social egg freezing really the answer? To freeze eggs, a woman has to go through almost a whole IVF cycle which includes injecting fertility drugs and having the eggs collected. The RCOG says we should be cautious as the data suggests the success rates are low, it is an expensive technique and there are side effects associated with egg freezing. Data from the Human Fertilisation and Embryology Authority (HFEA) suggests that only 1 in 5 women will get pregnant using frozen eggs, but it is key to break down this data by age. Just over 1000 women freeze their eggs per year but only 500 eggs were thawed in the UK and used in 2016. Some of these cycles are for medical reasons, such as chemo or radiotherapy.

The limitations of social egg freezing are that the eggs have to be frozen as ‘young’ as possible – ideally under 30-35 years of age and it is an expensive technique, costing about £5-7000 for one cycle. If you are under 35 years, 12 eggs may be enough but if you are over 35, more will be needed as the quality will be lower and women produce fewer eggs per cycle, so more cycles are needed.

If you are under 35 years, some clinics will reduce the price if you offer to donate some of your eggs to another couple but this needs to be considered carefully.

The RCOG report says: “Because of lower success rates per egg with increasing age, women in their late thirties would need approximately 30 eggs to have a good chance of achieving pregnancy. These women would, therefore, require on average three cycles of ovarian stimulation to produce enough eggs, at a cost of around £15,000 overall. This excludes an annual storage fee of £200-400 and the cost of future fertility treatment to use her frozen eggs.”

Besides the cost – the biggest concern is that this is no guarantee that these eggs will result in a pregnancy.  All women freezing their eggs need to be aware of this.

From a study I have conducted on women freezing their eggs, the majority did not have a partner and in line with the HFEA data, two thirds froze their eggs when they were over 35, which will significantly lower the success rate.

Sally Cheshire, the chair of the HFEA, says ‘we need clinics to be honest with women when they go for treatment – their chances of success, about the roller-coaster treatment they are under going, and their realistic chances of having a baby at the end of the day.”

And another issue in the UK is that the government have set a 10 year storage limit on social egg freezing. This does not apply if the eggs are frozen for medical reasons, such as chemotherapy, or for men who are having their sperm frozen before a vasectomy. In these cases, the eggs and sperm can be frozen for up  to 55 years. I am leading a petition to encourage government to increase the storage limit on social egg freezing – please sign the petition here if you are in the UK and here if you are outside the UK.

Geeta Nargund, owner of CREATE Fertility, suggests that the NHS should pay for women to freeze their eggs.  But I totally disagree. Egg freezing really is not the answer.

Surely what we really need is fertility education and the provision of working environments that support parents? This is exactly why I am one of the founders of the Fertility Education Initiative. We want to ensure that everyone thinks about their future and if they want a family. If they do, they need to be aware of how to achieve their fertility potential naturally, female fertility decline and the limitations of what fertility treatments, such as IVF, can offer. The chance of getting pregnant over 35 starts to rapidy decline and the chances over 40 are seriously reduced. Armed with this information, it is an individual choice of what is best for each of us.

We need to change views of society, such as has been achieved in some Scandinavia countries, to support working parents.

What do you think?

Read More:

The RCOG report – caution over social egg freezing

Discussion on the Victoria Derbyshire show, 8th August 2018, start watching at 1.07.30.

Vlog – Joyce Harper debates social egg freezing

Number of women freezing their eggs triples in 5 years

Joyce Harpers lecture on Reproduction without sex: what does technology have to offer?

Oocyte cryopreservation – where are we now?